A live-in carer was underpaid by £250,000 and a man with complex care needs put at risk after Hounslow Clinical Commissioning Group (CCG) failed to properly assess and provide for his health care, the UK national Ombudsman has found.
Hounslow Clinical Commissioning Group provided funding for Mr Q’s care under an NHS Continuing Healthcare (CHC) plan. The care plan funded a live-in carer for Mr Q.
Mr Q’s son complained to the Parliamentary and Health Service Ombudsman (PHSO) that his father's NHS Continuing Healthcare plan and Personal Health Budget (PHB) did not provide adequate cover to meet his father's needs. CHC is care provided to someone who has complex health care needs and can be provided in someone’s own home, a care home or another place outside a hospital, paid for by the NHS.
In this case, the CCG failed to assess and provide funding for required round-the-clock support for the patient, leaving the man’s live-in carer to work alone during nights when two carers were needed. The carer also consistently worked more than ten hours daily, for many years, to cover gaps in care provision. The CCG also failed to provide annual increases to fund the carer’s pay.
Hounslow Clinical Commissioning Group has since merged with other London CCGs to form the North West London Integrated Care Board (ICB). PHSO has directed the ICB to pay the former live-in carer £250,000 to compensate for the hundreds of unpaid hours worked, plus the failure to deliver annual uplifts in the care funding.
It has been two years since the Ombudsman published a landmark report outlining common failings seen in NHS CHC. The report found that failings, like those seen in this case, often resulted in families funding care when the NHS should have done so. PHSO said people were unaware of their entitlements and the processes to challenge decisions where they believe shortfalls are occurring in funding.
Parliamentary and Health Service Ombudsman Rob Behrens said:
“This case and our 2020 Continuing Healthcare report demonstrate the emotional, physical and financial toll such failures can have on families and carers. It has never been more important to highlight such failings as we deal with the cost-of-living crisis. The NHS must learn from these mistakes to avoid placing financial strain on the families of people with complex health care needs.
“They must also make sure that those providing care are paid for the service they deliver. Failure to do this risks the exploitation of those in carer roles and could put lives at risk.”
Find out more by downloading our full investigation report.